Forum - Questions & Answers

Nov 4th, 2009 - waknaus

Link between ICD-9 and clinical diagnoses ?

Does anyone know if there is an available resource that links multiple ICD-9 codes to generally accepted clinical diagnoses ? For example, there are codes for the many different etiologies of congestive heart failure, some of which have important clinical implications, others that may mean different reimbursement but are not clinically meaningful.

Nov 4th, 2009 - Codapedia Editor 1,399 

Link between ICD9 and clinical

I don't think I understand your question. On the physician side, reimbursement is tied to CPT not diagnosis code.

Nov 4th, 2009 -

I understand the question

The "sicker" the diagnosis, the higher the visit level can justify. So stable CHF 428.0 is less in intensity than acute exacerbation of systolic heart failure 428.21. So if Cigna has a program that compares the visit level to the diagnosis to see who to audit or reject then we want to be sure to code to the highest specificity.

But I do not know of a resource that can give you that info. Sorry



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